Long-term Results Of Leksell Gamma Knife Radiosurgery For Cushing?s Disease.

Keywords: Cushing's disease, gamma knife, pituitary adenoma, outcome, hormone dysfunction

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     The purpose of the study was to determine long-term efficacy and adverse effects of gamma knife radiosurgery for ACTH secreting pituitary adenomas.
     Among them twelve cases treated using GKR after transsphenoidal surgery. Three cases had prior conventional fractionated radiation therapy. The tumor margin was 28-35 Gy (median 31.7Gy). The mean follow-up was 6.8 years. Fifteen patients were lost to follow-up.
     Gamma knife radiosurgery has been used in Shanghai Gamma Knife Hospital as the primary or adjuvant therapy for the treatment of pituitary adenomas since Oct.1993. A review of data collected from GKR database between January 1995 and Dec 2002 was performed in 67 patients with Cushing''s disease.
     Tumor growth control was found in all patients. The ACTH levels declined in 49 patients, and normalized in 36 patients. No patient developed visual field defects or any other cranial nerve dysfunction. 23 patients started hormone substitution therapy during the follow-up period. And  the hypothyroidism was the most common endocrinopathy after GKS.
     This is a retrospective study.
     GKR as a primary surgical treatment and an adjuvant therapy for ACTH-secreting pituitary adenomas is effective.


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